L1-2 Disc Herniations: Clinical Characteristics and Surgical Results.

Lee, Sang Ho; Choi, Seokmin

Original Article

Journal of Korean Neurosurgical Society 2005;38(3): 196-201.

¹Department of Neurosurgery, Gimpo Airport Wooridul Spine Hospital, Seoul, Korea.
²Department of Neurosurgery, Spine Center, Myongji St. Mary's Hospital, Seoul, Korea. nsseokmin@krpost.net

ABSTRACT

OBJECTIVE
Among upper lumbar disc herniations, L1-2 disc herniations are especially rare. We present the specific clinical features of L1-2 disc herniation and compared results of different surgical options. METHODS: The authors undertook a retrospective single institution review of the patients who underwent surgery for L1-2 disc herniation. Thirty patients who underwent surgery for isolated L1-2 disc herniations were included. RESULTS: Buttock pain was more frequent than anterior or anterolateral thigh pain. Standing and/ or walking intolerance was more common than sitting intolerance. The straight leg raising test was positive only in 15 patients (50%). Iliopsoas weakness was more frequent than quadriceps weakness. Percutaneous discectomy group demonstrated worse outcome than laminectomy group or lateral retroperitoneal approach group. CONCLUSION: Standing and/or walking intolerance, positive femoral nerve stretch test, and iliopsoas weakness can be useful clues to the diagnosis of L1-2 disc herniation. Posterior approach using partial laminectomy and medial facetectomy or minimally invasive lateral retroperitoneal approach seems like a better surgical option for L1-2 disc herniation than percutaneous endoscopic discectomy.

Key Words: Upper lumbar disc; Herniation; Buttock pain